The long-term objective of this project is to improve the detection of one of the common human cancers arising in the bladder by non-invasive voided urine-based tests. Bladder cancer is the 4th most frequent in men and 5th most common overall with approximately 70,500 new cases and 14,600 deaths from the disease in 2009 in the United States. It is estimated that nearly 300,000 patients are regularly monitored in the United States through a variety of non-invasive (urine) and minimally invasive (bladder barbotage, cystoscopy, and biopsy) techniques. Therefore, the development of novel biomarkers that can detect bladder tumors by a non-invasive approach is of major clinical significance. In this grant, we propose to complement the existing Multi-Institutional Aurora kinase A FISH Test Biomarker Validation Trial by novel FISH markers and explore the role of Aurora kinase A in bladder cancer progression. We will compare the specificity and sensitivity of aurora A FISH test complemented by a panel of novel FISH markers with other known noninvasive bladder cancer detection tests for voided urine sediments such as urine cytology and commercially available multi-chromosomal FISH kit known as UroVysion, and NMP22 point-of-care test. A panel of novel FISH markers will be developed by whole-organ histologic and genetic mapping (WOHGM) strategy combined with high resolution (IM) lllumina SNP-based genotyping, which provides unique information on the chronology of genomic alterations that parallel the development of bladder cancer from early field effects to invasive disease. Our strong preliminary data indicate that this approach offers a unique opportunity to design novel biomarkers that may address the specific phases of bladder cancer development along these superficial papillary and high grade nonpapillary Invasive pathways. Moreover, we propose to investigate the role of aurora kinase A and its regular pathway in bladder cancer progression to invasive disease and distant metastasis. The specific aims of this project are as follows: Specific Aim 1: Develop a panel of novel FISH markers for bladder cancer. Specific Aim 2: Validate a novel set of FISH biomarkers for bladder cancer. Specific Aim 3: Investigate the role of Aurora kinase A in bladder cancer growth, angiogenesis, invasion and metastasis.